| NPI | 1134832249 |
|---|---|
| Former Name | EMILY JORDAN PRUIM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71013664A) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IN 28236379A) |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2023-04-30 |